Significant Reduction In Death Rate Research Articles

Colorectal Cancer Detection Using Targeted LC-MS Metabolic Profiling.

Colorectal cancer (CRC) is one of the most commonly diagnosed malignancies and causes of cancer death. While the mortality rates from CRC have steadily declined, 50,000 individuals in the USA (and many times this number worldwide) still succumb to this illness every year. Early detection of CRC is the most critical need for improving 5-year survival and cure rates. Currently available CRC diagnostic techniques often miss early stage disease such that only 40% of newly diagnosed CRC patients are treated for local disease, Therefore, development of new screening methods that are highly sensitive, specific, noninvasive and easily accessible are critically desired for the early diagnosis and significant reduction in death rate from CRC. In this chapter we describe a targeted LC-MS based metabolic profiling approach used for the discovery of CRC metabolite biomarker candidates, based on highly reproducible hydrophilic interaction liquid chromatography coupled to triple-quadrupole mass spectrometry (HILIC-LC-QQQ-MS). A partial least squares-discriminant analysis (PLS-DA) model was able to differentiate CRC patients from both healthy controls and polyp patients, as well as to distinguish CRC patients based on the cancer stage.

¿Pasó de largo por la España interior la primera fase de la transición demográfica? La mortalidad en Ávila y Guadalajara, 1700-1895

What happened in inland Spain during the first phase of the European demographic transition? Was there a significant reduction in death rates over the long run? This article aims to answer these questions. The main sources used in the work are the registers of baptisms and deaths corresponding to different locations of the provinces of Avila and Guadalajara. The most important conclusions are: (1)inland Spain did not remain apart from the initial phase of the European demographic transition since death rates tended to decline from the mid-eighteenth century, albeit with significant interruptions and fluctuations; (2)the decrease in ordinary mortality contributed more to that decline than that of the extraordinary mortality; (3)infant and child death rates fell less than that of adults, and (4)the total death rate remained unchanged or slightly increased between 1860 and 1889.

The power of data: using routinely collected data to improve public health programmes and patient outcomes in low‐ and middle‐income countries

‘We are data rich, but information poor!’ So said one of the senior Ministry of Health officials in Fiji when a team from the International Union Against Tuberculosis and Lung Disease and the University of Fiji was discussing the start of an operational research capacity building initiative in that country two years ago. This statement probably sums up the situation for many Ministries of Health and NonGovernmental Organizations (NGOs) in lowand middleincome countries (LMIC), where large amounts of data are regularly collected and collated from health facilities, filed away or shelved and never used, analysed or interpreted to drive improved performance of health services, the scale up of interventions or better outcomes for patients. This paradigm needs to change. Furthermore, such data could be used in the context of operational research to ask more farreaching questions about quality, coverage, safety and effectiveness of programmes or health systems. National tuberculosis control programmes (NTPs) throughout the world serve as a model for data collection. One of the essential components of the WHO Stop TB Strategy is a standardised monitoring, evaluation and reporting system to account for all TB cases diagnosed along with their treatment outcomes through cohort monitoring (WHO 2006). Within well-functioning NTPs, TB officers review patient data every three months in terms of who and how many are accessing treatment, whether treatment outcomes are satisfactory, and whether adverse outcomes such as death or loss to follow-up are being kept to a minimum. These data are used to assess programme performance, and they also serve as the foundation for district and national drug forecasting and procurement. The routine data can also form the basis of operational research, which we define as research into strategies, interventions, tools or knowledge that can enhance the quality, coverage, effectiveness or performance of the health system or disease programme in which the research is being conducted (Zachariah et al. 2009). Between 1996 and 2005, the Malawi NTP formally incorporated operational research into its routine activities, and a large number of research projects were undertaken to improve policy and practice and reduce morbidity and mortality of patients (WHO 1999). One particular example concerned high case-fatality rates in HIV-infected TB patients before the advent of antiretroviral therapy (ART). The country undertook a series of district-based operational research studies to determine whether it was feasible to offer a package of HIV testing and cotrimoxazole preventive therapy (CPT) to TB patients registered under routine programme conditions (Harries et al. 2011). Using routinely collected data, and paying particular attention during this time to ensuring that mortality data were reliable and complete, the studies showed a significant reduction in death rates of between 20–25%. This evidence persuaded the Malawi Ministry of Health to support the scale up of HIV testing and CPT countrywide for TB patients, and activities started soon after completion of the research in 2003. Between 2002 and 2008, routinely collected data showed a significant increase in HIV testing amongst TB patients with the majority of HIVpositive patients being started on CPT. Treatment outcomes in new smear-positive pulmonary TB patients

Adding ZPP to Cancer Detection

Biomedicine Like many other cancers, prostate cancer is more responsive to therapy when it is diagnosed at an early stage. Blood tests for PSA (prostate-specific antigen), a cancer screening strategy introduced over two decades ago, have led to a significant reduction in death rates from the disease

Ecological strategies and fitness tradeoffs inEscherichia coli mutants adapted to prolonged starvation

Many bacteria in nature are nutritionally deprived, and there has been heightened interest during the past decade in the properties of these bacteria. We subjected five populations ofEscherichia coli to prolonged starvation in a minimal salts medium, during which time the density of viable cells declined by several orders of magnitude. From each one, we isolated a surviving clone that showed some heritable difference in colony morphology. We then characterized these mutants in two ecologically relevant respects. First, we determined the nature of their selective advantage, if any, during prolonged starvation. (i) Three of the five mutants had significantly lower net death rate when progenitor and mutant clones were starved separately. (ii) Three mutants showed a significant reduction in death rate in mixed culture that was frequency dependent and manifest when the mutant clone was initially rare. This pattern suggests that these mutants fed on some byproduct of progenitor cells (living or dead). (iii) Two mutants caused the death rate of their progenitors to increase significantly relative to the rate measured in the absence of the mutant. This pattern suggests that these mutants had become allelopathic to their progenitors. Thus, three distinct ecological adaptations to prolonged starvation are evident. No advantage was detected for one mutant, whereas two mutants exhibited multiple advantages. Second, we asked whether the starvation-selected mutants were as fit in growth-supporting conditions as their progenitors. All five mutants were inferior to their progenitor during competition in fresh medium. Evidently, there is an evolutionary tradeoff between performance under growth and starvation conditions.

CONTROLLED TRIAL OF TAMOXIFEN AS SINGLE ADJUVANT AGENT IN MANAGEMENT OF EARLY BREAST CANCER: Analysis at Six Years by Nolvadex Adjuvant Trial Organisation

A randomised controlled trial of tamoxifen as a single adjuvant agent after mastectomy for early breast cancer, reported on at an average follow-up of almost 2 years in 1983, has now been followed up to a maximum of 6 years. 1285 patients aged 75 or less were entered into the trial. Premenopausal women with positive axillary nodes and postmenopausal women with both positive and negative axillary nodes were randomised to receive either tamoxifen 10 mg twice daily for two years or to the untreated control group with systemic therapy reserved until the time of relapse. 46% of the trial population had primary tumour specimens assayed for oestradiol receptor (ER) content. There has been a highly significant prolongation of the disease-free interval in the tamoxifen-treated group followed by a highly significant reduction in death rate, with 45(34%) fewer deaths observed in the treated group than in the control group. This benefit appeared to be independent of menopausal, nodal, or ER status.

Role of percutaneous transhepatic obliteration of varices in the management of hemorrhage from gastroesophageal varices

One hundred and forty-one attempts at percutaneous transhepatic variceal obliteration were made in 116 patients with portal hypertension complicated by variceal hemorrhage. Varices were successfully obliterated in 80% of procedures and included 37 patients with continuous, acute variceal hemorrhage. Hemorrhage ceased immediately in these patients. Sixty-five percent of patients rebled a mean of 4.6 mo after successful transhepatic variceal obliteration. A randomized controlled trial against conventional medical therapy (29 treatment, 25 control) failed to show a significant reduction in death rate after transhepatic sclerotherapy, although the onset of further variceal hemorrhage was delayed. Follow-up portography in 50 patients demonstrated new vessel formation in 38 patients and recanalization of previously occluded varices in 5 patients. Complications arose in 29 of 141 procedures. There was one death but all the other complications responded to conservative management. Transhepatic variceal obliteration is an excellent, safe emergency treatment for variceal hemorrhage, especially in patients with decompensated liver disease. A high incidence of rebleeding is a long-term disadvantage and means that transhepatic variceal obliteration should not be used for the prophylaxis of variceal hemorrhage. Successful emergency treatment of variceal hemorrhage should be followed by elective portal decompression in suitable patients.